Q: What do Donald Trump, Elizabeth Holmes, and an alarming fraction of the vaccine “skeptics” have in common?
A: Apparently, a belief in their own personal immunity from the basic laws of cause and effect.

Let’s start with Trump.

Well, first, let’s back up and think for a moment about that unnatural alliance between evangelical Christians and big business. Why do so many members of the white working class vote for policies that take good things away from themselves and people like them and add them to the absurd stockpiles of the ultra-rich? Part of that’s probably aspirational – people tend to vote on behalf of the future selves they hope to be rather than their actual circumstances, and thanks to lotteries, too many people expect to hit the jackpot.

But there’s a cultural reason, too. One trend in evangelical thinking is called the Prosperity Gospel, which has its roots in earlier Calvinism. John Calvin, one of the leaders in early Protestantism, taught that you can’t earn your way into Heaven, but that God tends to reward people on Earth commensurate with their religious merits. It’s a capitalist version of karma – if you’re rich, it’s because God sees the good in you. If you’re poor… maybe you deserve it, or maybe you should just be patient and trust in God. Politics has nothing to do with it. Then this got wrapped up with positive thinking, where you should act like the person you want to be until it comes true.

And Donald Trump’s version with Christianity is right in line with this. Imagine your desired reality is true, and… it will be, assuming God shows up to do His part.

His presidential campaign and presidency were rife with examples. In 2015, he promised universal health care. In 2016, he said he would get rid of the national debt and rebuild America’s infrastructure. As for COVID? “Just stay calm, it will go away.”

To some extent, Trump’s practices were like leadership. The leader makes a decision, and their subordinates get to work and make it happen. But when Star Trek’s Jean-Luc Picard would say, “Make it so,” his faith in the result was justified because he thoroughly understood all the underlying systems involved – the science, the engineering, the skills of his crew, and the whole cause-and-effect of 24th-century problem-solving.

Not so for Donald Trump. Maybe when real estate moguls make pronouncements, their legal teams can scurry about, putting things in motion and cleaning up the messes, but it doesn’t work quite like that for U.S. presidents. His declarations became so grandiose that their sheer impossibility was mind-boggling – he seemed to lack the basic awareness that there are underlying processes involved. He even undermined the systems a president needs, by putting incompetent people into positions of power and by condemning ordinary government workers as some sort of “Deep State conspiracy.”

Some systems are flexible. If they’re made by humans, they’re not as rigid as the laws of Nature. If you don’t like the federal tax code, your billions of dollars can maybe insulate you from its effects – but try throwing money at the Law of Gravity? Nope.

Science, on the other hand, is a human-made system dedicated to understanding Nature’s systems. As a human enterprise, it has its problems too, of course, but we’ve all benefitted more than we can imagine from the medicine and technology that Science has made possible. We may not have beaten the Law of Gravity, but we can work with it to fly around the world and send humans to the Moon.

The reason I was thinking about this is because my friend E. was telling me about the Elizabeth Holmes scandal. We’ll be hearing her name a lot in the news – she’s being tried in federal court for fraud.

Until recently, Elizabeth Holmes was a big deal in Silicon Valley. The youngest female billionaire, she was able to line up quite a few big-name investors for her start-up company, Theranos, which was developing a product to diagnose more than two hundred diseases from one drop of blood.

Medical testing is a huge industry, as anyone knows whose physician has ever noticed anything slightly outside the range of usual expectations. It’s time-consuming, costly, and very stressful. If we could skip past all that and learn everything with just a pinprick – what a dream!

But… it didn’t work. And when her ideas weren’t going to work, she didn’t listen. Earlier, she’d wanted to make a patch that would scan the person wearing it for infections and distribute antibiotics accordingly. A Stanford expert who told her it wouldn’t work reported that “she just stared through me,” seeming “absolutely confident in her own brilliance” and not willing to hear otherwise.

Any Theranos employee who questioned the feasibility of their supposed product? Fired. A Cambridge scholar whom she’d hired, initially assured by the presence of Henry Kissinger, George Shultz, and other big names on the Theranos board of directors, soon realized it was all smoke and mirrors and ended up committing suicide.

Maybe Holmes is a visionary. Maybe she’s a sociopath. Or both? We can’t get inside her head. But even the most generous interpretation of her behavior says that she believed that what she wanted to happen would happen, through the sheer force of her will.

If that’s true, then Holmes and Trump are both instances of trusting too much in their own selves and their own willpower but eventually running afoul of what’s actually possible.

This same kind of thinking is part of what’s going on with vaccine skepticism. Some people believe in themselves too much, imagining they can override the laws of Nature, and ignoring all the other facets of their lives where trusting the human systems of medicine and engineering is something they do every day. Or worse, they mistrust medicine because it’s a mainstream system (a reasonable if unfortunate stance for those whose people have been exploited or ignored by the system), but then maybe they turn around and do trust the supposed “inside knowledge” they get from random conspiracy types on the Internet, risking their health with weird and dangerous alternatives.

So – trusting the system. Should you do it? Captain Picard can trust his systems to “make it so.” Trump and perhaps Holmes trust themselves so much that they think they can ignore the systems… right up until they can’t. As for the rest of us, let us give thanks for the advances in science that have given us reliable vaccines against SARS-CoV-2. Our systems aren’t perfect, but they do make some good things possible.